NECROTIZING FUNISITIS ASSOCIATED WITH ACTINOMYCES-MEYERI INFECTION - A CASE-REPORT

Necrotizing funisitis is associated with an increased rate of stillbir th, perinatal infection, and preterm delivery. No one organism has bee n associated with necrotizing funisitis, although this condition has b een linked with congenital syphilis in some studies. We report a case of necrotizing funisitis in a 24-year-old G2POA2 woman who experienced preterm labor at 31 weeks of gestation. Examination of the placenta r evealed severe chorioamnionitis and necrotizing funisitis; large numbe rs of gram-positive filamentous branching organisms could be seen on t he surface of the cord and within Wharton jelly. Initial cultures of t he placenta, which had not been maintained under anaerobic conditions after delivery, were negative. A fragment of the cord was then homogen ized; anaerobic culture on brain-heart infusion agar yielded Actinomyc es meyeri. This organism usually resides in the periodontal sulcus and has not been previously reported in the female genital tract. The mot her gave a history of a dental abscess that flared up and drained with each of her three pregnancies; the pain was particularly severe durin g the last 2 months of this pregnancy, so she had the tooth removed af ter delivery. The infant was treated for prematurity and presumed seps is and did well.